2020-06-03T16:19:11-05:00 2019-06-30 520783935 SMITH ELLIOTT KEARNS & COMPANY LLC 19 BROOKWOOD AVE STE 101 CARLISLE PA 17015 990 2018-07-01 230465970 THE CHAMBERSBURG HOSPITAL CHAM 7178513055 PO BOX 2767 YORK PA 174052767 MICHAEL F O'CONNOR CFO WELLSPAN HEALTH 7172673000 2020-06-01 true GREGORY P HALL CPA P00156653 7172439104 2020-06-01 65.144.154.59 2020-06-03 16:19:11 CD P 6B3D5CFE32BBD35C7631821135029589AD16E6BC 8C3DE7AC8B2B6548563FFD49837976E3A40C018B 2018 2021-01-29 14:40:06Z EXTENDED TO 7152020 WELLSPAN CHAMBERSBURG HOSPITAL ROXANNA GAPSTUR PO BOX 2767 YORK PA 174052767 470215789 false X WWW.SUMMITHEALTH.ORG X 1904 PA THE CHAMBERSBURG HOSPITAL IS A REGIONAL NONPROFIT HEALTH CARE ORGANIZATION COMMITTED TO THE IMPROVEMENT OF THE HEALTH AND WELL-BEING OF THE PEOPLE IN SOUTH-CENTRAL PENNSYLVANIA. 13 9 2445 449 3920040 458257 636432 346841987 368292235 4869129 17533667 6000979 6781923 358170352 393244257 2316680 1803710 0 173189699 168761193 0 0 132939202 161382601 308445581 331947504 49724771 61296753 504783786 488841565 215445267 230940319 289338519 257901246 THE CHAMBERSBURG HOSPITAL IS A REGIONAL NONPROFIT HEALTH CARE ORGANIZATION COMMITTED TO THE IMPROVEMENT OF THE HEALTH AND WELL-BEING OF THE PEOPLE IN SOUTH-CENTRAL PENNSYLVANIA. false false 243148714 370816312 THE CHAMBERSBURG HOSPITAL PROVIDES NEEDED MEDICAL CARE TO THE COMMUNITY REGARDLESS OF ANY PATIENT'S ABILITY TO PAY. HEALTH CARE SERVICES INCLUDE INPATIENT ROUTINE, INPATIENT ANCILLARY AND OUTPATIENT CARE. ALL MANAGEMENT AND GENERAL EXPENSES ARE CONSIDERED PROGRAM RELATED. 1803710 1803710 GRANTS TO VARIOUS NON-PROFIT ORGANIZATIONS IN THE COMMUNITY TO DEVELOP OR EXPAND HEALTH CARE PROGRAMS TO EDUCATE THE COMMUNITY ABOUT HEALTH CARE ISSUES. CHAMBERSBURG HOSPITAL PARTNERS WITH COMMUNITY ORGANIZATIONS TO ENHANCE, PROMOTE, AND OFFER COMMUNITY PROGRAMS FOR THE HEALTH AND WELL BEING OF RESIDENTS IN SOUTH CENTRAL PENNSYLVANIA. 244952424 true true false false false false false false false true true true false false true true false true false false false false false false false false true true true false true true false false false false false false false false false false false false false false false true false false false true 165 0 true 2445 true true true false false false false false false false false false true false X 13 9 false false false false true true true true true false false true true true true true true true true true true PA X DAVID P RIZZUTO SENIOR CONTROLLER 7178513055 PO BOX 2767 YORK PA 174052767 CHERYL PLUMMER CHAIR 0.17 X X 0 0 0 SUZANNE MILLER TRINH VICE CHAIR 0.14 X X 0 0 0 PAUL LUKA SECRETARY 0.11 X X 0 0 0 PATRICK W O'DONNELL PRESIDENT & 24.17 16.00 X X 1148326 765551 310020 KIMBERLY M RZOMP TREASURER / 26.00 14.00 X 371056 199799 72744 DR KEVIN LORENTSEN DIRECTOR 0.17 40.00 X 0 485675 26422 JEFF REEDER DIRECTOR 0.00 X 0 0 0 L MICHAEL ROSS DIRECTOR 0.17 X 0 0 0 MICHAEL STARR DIRECTOR 0.05 X 0 0 0 JOHN VANHORN DIRECTOR 0.08 X 0 0 0 JOANNE COCHRAN DIRECTOR 0.17 X 0 0 0 DR W DAVID KENT DIRECTOR 0.17 X 0 0 0 DR JOSHUA DUNKLEBARGER DIRECTOR 0.14 40.00 X 0 949004 27354 ROXANNA GAPSTUR BEGINNING 112019 CEO WELLSPAN 40.00 X 0 0 0 KEVIN MOSSER ENDING 123118 CEO WELLSPAN 40.00 X 0 4267289 111748 MICHAEL F O'CONNOR CFO WELLSPAN 40.00 X 0 811162 641117 THOMAS ANDERSON MD VP MEDICAL A 32.00 8.00 X 412231 103058 59590 HARRY DIEUVEUIL VP HUMAN RES 40.00 0.00 X 188459 0 22593 JOHN MASSIMILLA VP ADMIN/COO 40.00 X 365414 0 76668 BARBARA ROSSINI VP PLANNING 30.00 10.00 X 219964 73320 49898 SHERRI STAHL SR VP HOSPIT 32.00 8.00 X 414506 103626 68356 MICHELE ZEIGLER VP INFORMATI 28.00 12.00 X 242043 103733 59358 CATHY PUHL VP HUMAN RES 40.00 X 221790 0 48204 CAROLYN GEORGE VP CORPORATE 40.00 X 220520 0 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331947504 SCHEDULE D, PAGE 2, PART V, LINE 4 ENDOWMENT FUNDS ARE TO BE USED FOR THE DEVELOPMENT OR EXPANSION OF COMMUNITY HEALTHCARE INITIATIVE AND PROGRAMS. FUNDS ARE ALSO USED TO EDUCATE THE COMMUNITY ABOUT HEALTHCARE ISSUES. SCHEDULE D, PAGE 3, PART X IN JUNE 2006, THE FINANCIAL ACCOUNTING STANDARDS BOARD (FASB) ISSUED INTERPRETATION NO. 48, ACCOUNTING FOR UNCERTAINTY IN INCOME TAXES - AN INTERPRETATION OF FASB STATEMENT NO. 109, ACCOUNTING FOR INCOME TAXES (FIN 48), WHICH CREATES A SINGLE MODEL TO ADDRESS UNCERTAINTY IN TAX POSITIONS AND CLARIFIES THE ACCOUNTING FOR INCOME TAXES BY PRESCRIBING THE MINIMUM RECOGNITION THRESHOLD A TAX POSITION IS REQUIRED TO MEET BEFORE BEING RECOGNIZED IN THE FINANCIAL STATEMENTS. UNDER THE REQUIREMENTS OF FIN 48, TAX-EXEMPT ORGANIZATIONS COULD NOW BE REQUIRED TO RECORD AN OBLIGATION AS THE RESULT OF A TAX POSITION THEY HAVE HISTORICALLY TAKEN OR VARIOUS TAX EXPOSURE ITEMS. PRIOR TO FIN 48, THE DETERMINATION OF WHEN TO RECORD A LIABILITY FOR TAX EXPOSURE WAS BASED ON WHETHER A LIABILITY WAS CONSIDERED PROBABLE AND REASONABLY ESTIMABLE IN ACCORDANCE WITH SFAS NO. 5, ACCOUNTING FOR CONTINGENCIES. ON JULY 1, 2007, THE PARENT COMPANY, WELLSPAN HEALTH, ADOPTED FIN 48. WELLSPAN HEALTH DETERMINED THAT IT DOES NOT HAVE ANY UNCERTAIN TAX POSITIONS THROUGH JUNE 30, 2019. SCHEDULE D, PAGE 4, PART XI, LINE 4B BAD DEBT EXPENSE 25,600,767 SCHEDULE D, PAGE 4, PART XII, LINE 4B BAD DEBT EXPENSE 25,600,767 true true X true X true X true true false true true 3582091 3582091 0.01080 44351627 23661231 20690396 0.06230 47933718 23661231 24272487 0.07310 34 11811 177216 177216 0.00050 4 2234 193240 193240 0.00060 2 2142757 2142757 0.00650 1 153949 153949 0.00050 4 2389700 2389700 0.00720 45 14045 5056862 5056862 0.01520 45 14045 52990580 23661231 29329349 0.08840 1 5867 5867 2 15 606 606 3 15 6473 6473 false 25600767 52243437 84402826 -32159389 X true true 1 1 WELLSPAN CHAMBERSBURG HOSPITAL 112 NORTH SEVENTH STREET CHAMBERSBURG PA 17201 WWW.SUMMITHEALTH.ORG X X X WELLSPAN CHAMBERSBURG HOSPITAL 1 false false true X X X X X X X X X X 18 true true true true X WWW.SUMMITHEALTH.ORG X WWW.HEALTHYFRANKLINCOUNTY.COM X X true 19 true WWW.SUMMITHEALTH.ORG false false true X 200.000000000000 300.000000000000 X true true X X X X true X WWW.SUMMITHEALTH.ORG X WWW.SUMMITHEALTH.ORG X WWW.SUMMITHEALTH.ORG X X X X X X X true X false X X X X X true X false false FACILITY 1, WELLSPAN CHAMBERSBURG HOSPITAL - PART V, LINE 3E FRANKLIN COUNTYS MOST SIGNIFICANT NEEDS FOCUS ON TWO SOCIAL DETERMINANTS AND TWO BEHAVIORAL HEALTH PRIORITIES: ESTABLISHING AND MAINTAINING THE BASIC CONDITIONS THAT SUPPORT HEALTH, INCLUDING, ACCESS TO CARE, FAMILY-SUSTAINING INCOMES, ACCESSIBLE TRANSPORTATION, REDUCED STRESS, AND AFFORDABLE AND QUALITY HOUSING ESTABLISHING AND MAINTAINING SYSTEMS THAT ASSURE THAT CHILDREN AND FAMILIES HAVE ACCESS TO HIGH QUALITY EDUCATIONAL OPPORTUNITIES THROUGHOUT THE LIFESPAN SUPPORTING IMPROVED MENTAL HEALTH INCLUDING REDUCING AND TREATING SUBSTANCE USE SUPPORTING ACTIVE LIVING, HEALTHY EATING, AND LESS OBESITY FACILITY 1, WELLSPAN CHAMBERSBURG HOSPITAL - PART V, LINE 5 THE SUMMIT HEALTH MANAGEMENT TEAM, HEALTHY FRANKLIN COUNTY LEADERSHIP ADVISORY COMMITTEE, AND THE CENTER FOR OPINION RESEARCH AT FRANKLIN AND MARSHALL COLLEGE CONTRIBUTED TO THE DEVELOPMENT OF THE COMMUNITY HEALTH NEEDS ASSESSMENT (CHNA) AND THE COMMUNITY HEALTH IMPROVEMENT PLAN (CHIP). ONE MAJOR INITIATIVE INCLUDED A SERIES OF SEVEN FOCUS GROUPS WITH COMMUNITY MEMBERS IN THE SUMMIT HEALTH SERVICE AREA. THE GOAL OF THESE FOCUS GROUPS WAS TO GATHER INFORMATION ABOUT FRANKLIN COUNTYS TOP COMMUNITY HEALTH NEEDS FROM THE PERSPECTIVE OF TARGETED COMMUNITY INFORMANTS THAT INCLUDED SCHOOLS, LOW-INCOME, MINORITY, AND SENIOR POPULATIONS. A SECOND TOOL WAS A SURVEY OF 51 VETERANS CONDUCTED BY THE COMMUNITY SERVICES TEAM AT SUMMIT HEALTH. THIS SURVEY WAS DESIGNED TO CLOSELY MIRROR THE COMMUNITY BEHAVIORAL RISK FACTOR SURVEY AND PROVIDE MORE DETAILS ABOUT THE HEALTH CONDITIONS, RISKS, AND BEHAVIORS OF THIS POPULATION. IN ADDITION TO THE FOCUS GROUPS AND VETERANS SURVEY, SUMMIT HEALTH HOSTED A STAKEHOLDER FORUM ON APRIL 15, 2019 WITH MEMBERS OF THE HEALTHY FRANKLIN COUNTY LEADERSHIP TEAM. THE THREE PRIMARY GOALS OF THE FORUM WERE TO: (1) EXPLAIN THE CHNA PROCESS AND THE ROLE OF COMMUNITY STAKEHOLDERS; (2) PRESENT THE ANALYTIC FRAMEWORK AND PRELIMINARY COMMUNITY HEALTH DATA INCLUDED IN THIS SUMMARY; AND (3) GATHER INPUT FROM THESE COMMUNITY STAKEHOLDERS WHO HAVE PUBLIC HEALTH EXPERTISE OR SERVE MEDICALLY UNDERSERVED, LOW-INCOME, AND MINORITY POPULATIONS IN FRANKLIN COUNTY, ABOUT COMMUNITY HEALTH NEEDS AND COMMUNITY RESOURCES. FACILITY 1, WELLSPAN CHAMBERSBURG HOSPITAL - PART V, LINE 6A WAYNESBORO HOSPITAL FACILITY 1, WELLSPAN CHAMBERSBURG HOSPITAL - PART V, LINE 6B HEALTHY FRANKLIN COUNTY FACILITY 1, WELLSPAN CHAMBERSBURG HOSPITAL - PART V, LINE 7D THE 2018-2019 SUMMIT HEALTH COMMUNITY HEALTH NEEDS ASSESSMENT (CHNA) IS AVAILABLE FOR REVIEW BOTH ON THE WEBSITE: WWW.HEALTHYFRANKLINCOUNTY.ORG OR ON THE WEBSITE: WWW.SUMMITHEALTH.ORG. A PRINTED COPY OF THE REPORT MAY BE OBTAINED UPON REQUEST TO: WELLSPAN SUMMIT HEALTH, ANN SPOTTSWOOD, DIRECTOR OF COMMUNITY SERVICES, ASPOTTSWOOD@SUMMITHEALTH.ORG. FACILITY 1, WELLSPAN CHAMBERSBURG HOSPITAL - PART V, LINE 11 THE COMMUNITY HEALTH NEEDS ASSESSMENT PROCESS ENCOURAGES COMMUNITIES TO REFLECT ON THE INITIATIVES THEY HAVE UNDERTAKEN AND THEIR SUCCESSES IN ADDRESSING THE HEALTH PRIORITIES THEY HAVE ESTABLISHED. SINCE 2015, SUMMIT HEALTH'S COMMUNITY SERVICES TEAM ENGAGED WITH THE COMMUNITY TO ESTABLISH SPECIFIC ACTIVITIES TARGETED TO IMPROVING COMMUNITY HEALTH IN SEVEN PRIORITY AREAS. THE COMMUNITY PRIORITIES, GOALS, AND ACTIVITIES RESULTING FROM THE 2015 COMMUNITY HEALTH NEEDS ASSESSMENT PROCESS ARE FULLY DESCRIBED IN APPENDIX I OF THE 2018-2019 SUMMIT HEALTH COMMUNITY HEALTH NEEDS ASSESSMENT. THE SEVEN PRIORITY AREAS ESTABLISHED IN 2015 INCLUDE ACCESS TO PRIMARY CARE SERVICES, NUTRITION, PHYSICAL ACTIVITY, MENTAL HEALTH AND SUBSTANCE USE AND PREVENTION, EDUCATION AND COMMUNITY BASED EDUCATION, EARLY CHILDHOOD EDUCATION, AND ADOLESCENT HEALTH. TABLE 8 OF THE 2018-2019 SUMMIT HEALTH COMMUNITY HEALTH NEEDS ASSESSMENT SHOWS THE NUMBER OF INITIATIVES IMPLEMENTED AND HEALTH INDICATORS RELATED TO EACH. THE COMMUNITY, LED BY SUMMIT HEALTH AND THE HEALTHY FRANKLIN COUNTY LEADERSHIP GROUP, CREATED MANY COMMUNITY INTERVENTIONS, WITH THE MOST EFFORT DEDICATED TO NUTRITION, FOLLOWED BY MENTAL HEALTH AND SUBSTANCE USE AND PREVENTION, PHYSICAL ACTIVITY, AND ACCESS TO CARE. UNFORTUNATELY, ALL OF THESE ACTIVITIES HAVE NOT YET PRODUCED MUCH COMMUNITY-LEVEL CHANGE. ACCESS TO CARE HAS REMAINED VIRTUALLY UNCHANGED WITH THE EXCEPTION OF HIGHER RATES OF DENTAL VISITS. INDICATORS RELATED TO NUTRITION AND PHYSICAL ACTIVITY HAVE GOTTEN WORSE. MENTAL HEALTH INDICATORS HAVE ALSO DECLINED. EDUCATION AND COMMUNITY BASED EDUCATION INDICATORS HAVE REMAINED VIRTUALLY UNCHANGED. ACCESS TO EARLY CHILDHOOD EDUCATION HAS IMPROVED AS HAVE TEEN BIRTH RATES AND TEEN CHLAMYDIA RATES. THESE RESULTS ARE REMINDERS OF AT LEAST TWO IMPORTANT TRUTHS ABOUT IMPROVING PUBLIC HEALTH. FIRST, EFFECTING CHANGE WILL REQUIRE MORE THAN THREE OR FOUR YEARS. MOST OF THE PUBLIC HEALTH PROBLEMS IN OUR COMMUNITIES HAVE EMERGED OVER LONG PERIODS OF TIME AND IT WILL REQUIRE A LONG-TERM AND SUSTAINED INVESTMENT TO PRODUCE CHANGE. SECOND, MOST OF THE INDICATORS USED HERE ARE TRAILING INDICATORS THAT REFLECT AT LEAST IN PART SOCIAL AND STRUCTURAL CONTEXTS THAT ARE LIKELY TO MOVE ONCE THOSE UNDERLYING CONDITIONS BEGIN TO CHANGE. PUT SIMPLY, TIME AND SOCIAL CHANGE ARE NECESSARY CONDITIONS FOR IMPROVING THE HEALTH OF A COMMUNITY. THE PRIORITIES AND IMPACTS ESTABLISHED BY THE 2015 COMMUNITY HEALTH NEEDS ASSESSMENT (CHNA) PROVIDE A SUMMARY OF THE WORK IMPLEMENTED GUIDED BY THE RESULTS OF THE PREVIOUS CHNA REGARDING THE SEVEN PRIORITY AREAS IDICATED ABOVE. TO ASSESS PROGRESS TOWARDS THESE GOALS, COMMUNITY INDICATORS FROM THE 2015 CHNA AND 2019 CHNA WERE COMPARED IN THE CATEGORIES OF ORGANIZATIONAL INDICATORS AND PRESENTED IN A TABLE IN THE CHNA ASSESSMENT REPORT. ACCESS TO CARE HAS REMAINED VIRTUALLY UNCHANGED WITH THE EXCEPTION OF HIGHER RATES OF DENTIST VISITS. NUTRITION AND PHYSICAL ACTIVITY HAS GOTTEN WORSE FOR ALL INDICATORS, DESPITE THE MANY ACTIVITIES COMPLETED AT AN ORGANIZATIONAL LEVEL TO ADDRESS THESE ISSUES. MENTAL HEALTH INDICATORS HAVE ALSO DECLINED. EDUCATION AND COMMUNITY BASED EDUCATION INDICATORS HAVE REMAINED VIRTUALLY UNCHANGED. ACCESS TO EARLY CHILDHOOD EDUCATION HAS IMPROVED. TEEN BIRTH RATE AND TEEN CHLAMYDIA RATES HAVE GONE DOWN, WHILE THE CHLAMYDIA RATE FOR YOUNG ADULTS HAS INCREASED. THESE RESULTS SHOULD BE VIEWED WHILE CONSIDERING ONE IMPORTANT POINT - IT TAKES TIME IN ORDER TO SEE CHANGES AT THE COMMUNITY LEVEL; SIMPLY BECAUSE AN INDICATOR HAS NOT CHANGED OR HAS DECLINED, DOES NOT MEAN THAT THE INTERVENTION HAS FAILED - THERE MAY BE MANY REASONS WHY A POSITIVE CHANGE HAS NOT OCCURRED. FACILITY 1, WELLSPAN CHAMBERSBURG HOSPITAL - PART V, LINE 16J INFORMATION AND APPLICATION CAN BE FOUND ON THE BACK OF A PATIENT BILLING STATEMENT. FACILITY 1, WELLSPAN CHAMBERSBURG HOSPITAL - PART V, LINE 20E FINANCIAL COUNSELORS CALL AND SEND LETTERS TO SELF PAY PATIENTS WITH HIGH DEDUCTIBLE PLANS THAT RECEIVE EMERGENCY DEPARTMENT, SURGICAL OR IN-PATIENT SERVICES. PART I, LINE 3C - OTHER INCOME BASED CRITERIA FOR FREE OR DISCOUNTED CARE IF A FAMILY HAS LIQUID ASSETS AVAILABLE, THEY ARE EXPECTED TO CONTRIBUTE TO THE COST OF THEIR CARE USING THOSE FUNDS. HOWEVER, THEY ARE NOT REQUIRED TO SPEND DOWN ALL OF THEIR LIQUID ASSETS IN ORDER TO BE ELIGIBLE FOR A DISCOUNT. PATIENTS MAY RETAIN SIX MONTHS OF LIVING EXPENSES FROM THEIR LIQUID ASSETS. SIX MONTHS OF LIVING EXPENSES IS ESTIMATED TO BE ONE HALF OF 300% OF FPG. AT THAT POINT, THEY RECEIVE A DISCOUNT ON THEIR MEDICAL BILL. PART I, LINE 7 - COSTING METHODOLOGY EXPLANATION THE INFORMATION WAS OBTAINED USING THE COST METHODS USED IN PREPARING THE MEDICARE COST REPORTS. PART II - COMMUNITY BUILDING ACTIVITIES CHAMBERSBURG HOSPITAL WORKS TO STRENGTHEN OUR COMMUNITY THROUGH HEALTH EDUCATION EFFORTS FOR CHILDREN AND ADULTS, HEALTH FAIRS PROVIDING HEALTH SCREENINGS, EDUCATING COMMUNITY GROUPS ON SPECIFIC HEALTH TOPICS, FUNDING HEALTH PROGRAMS BY LOCAL NONPROFIT ORGANIZATIONS THROUGH THE SUMMIT ENDOWMENT PROGRAM, PROVIDING CAPACITY-BUILDING WORKSHOPS AND ASSISTANCE THROUGH SUMMIT ENDOWMENT, PARTICIPATING IN MANY LOCAL CIVIC ORGANIZATIONS, SPONSORING EVENTS HELD BY LOCAL CHARITABLE ORGANIZATIONS, AND SUPPORTING WORKFORCE DEVELOPMENT INITIATIVES THROUGH SUMMIT HEALTH'S SCHOOL LIASON PROGRAMS. PART III, LINE 2 - BAD DEBT EXPENSE METHODOLOGY FOR RECEIVABLES ASSOCIATED WITH SELF-PAY PATIENTS (WHICH INCLUDES BOTH PATIENTS WITHOUT INSURANCE AND PATIENTS WITH DEDUCTIBLE AND COPAYMENT BALANCES DUE FOR WHICH THIRD-PARTY COVERAGE EXISTS FOR PART OF THE BILL), THE HOSPITAL RECORDS A PROVISION FOR BAD DEBTS IN THE PERIOD OF SERVICE ON THE BASIS OF ITS PAST EXPERIENCE, WHICH INDICATES THAT SOME PATIENTS ARE UNABLE OR UNWILLING TO PAY THE PORTION OF THEIR BILL FOR WHICH THEY ARE FINANCIALLY RESPONSIBLE. THE DIFFERENCE BETWEEN THE STANDARD RATES (OR THE DISCOUNTED RATES IF NEGOTIATED) AND THE AMOUNTS ACTUALLY COLLECTED AFTER ALL REASONABLE COLLECTION EFFORTS HAVE BEEN EXHAUSTED IS CHARGED OFF AGAINST THE ALLOWANCE FOR DOUBTFUL ACCOUNTS. THE COST TO CHARGE RATIO WAS USED TO CALCULATE THE COST OF BAD DEBT EXPENSE. THIS RATIO IS CALCULATED AS FOLLOWS: (NET PATIENT REVENUE DIVIDED BY THE TOTAL OPERATING REVENUE MULTIPLIED BY THE TOTAL OPERATING EXPENSE) DIVIDED BY THE GROSS PATIENT REVENUE. BAD DEBT EXPENSE FOOTNOTE TO FINANCIAL STATEMENTS THE HOSPITAL PROVIDES CREDIT IN THE NORMAL COURSE OF ITS BUSINESS TO PATIENTS. PATIENT RECEIVABLES ARE BASED ON THE OUTSTANDING PATIENT BALANCE AFTER ANY CONTRACTUAL REIMBURSEMENTS ARE APPLIED AND ARE GENERALLY DUE 30 DAYS AFTER BILLED. ACCOUNTS RECEIVABLE ARE REDUCED BY AN ALLOWANCE FOR DOUBTFUL ACCOUNTS. IN EVALUATING THE COLLECTIBILITY OF ACCOUNTS RECEIVABLE, THE HOSPITAL ANALYZES ITS PAST HISTORY AND IDENTIFIES TRENDS FOR EACH OF ITS MAJOR PAYOR SOURCES OF REVENUE TO ESTIMATE THE APPROPRIATE ALLOWANCE FOR DOUBTFUL ACCOUNTS AND PROVISION FOR BAD DEBTS. MANAGEMENT REGULARLY REVIEWS DATA ABOUT THESE MAJOR PAYOR SOURCES OF REVENUE IN EVALUATING THE SUFFICIENCY OF THE ALLOWANCE FOR DOUBTFUL ACCOUNTS. FOR RECEIVABLES ASSOCIATED WITH SERVICES PROVIDED TO PATIENTS WHO HAVE THIRD-PARTY COVERAGE, THE HOSPITAL ANALYZES CONTRACTUALLY DUE AMOUNTS AND PROVIDES AN ALLOWANCE FOR DOUBTFUL ACCOUNTS AND A PROVISION FOR BAD DEBTS, IF NECESSARY (FOR EXAMPLE, FOR EXPECTED UNCOLLECTIBLE DEDUCTIBLES AND COPAYMENTS ON ACCOUNTS FOR WHICH THE THIRD- PARTY PAYOR HAS NOT YET PAID, OR FOR PAYORS WHO ARE KNOWN TO BE HAVING FINANCIAL DIFFICULTIES THAT MAKE THE REALIZATION OF AMOUNTS DUE UNLIKELY). FOR RECEIVABLES ASSOCIATED WITH SELF PAY PATIENTS (WHICH INCLUDES BOTH PATIENTS WITHOUT INSURANCE AND PATIENTS WITH DEDUCTIBLE AND COPAYMENT BALANCES DUE FOR WHICH THIRD-PARTY COVERAGE EXISTS FOR PART OF THE BILL), THE HOSPITAL RECORDS A PROVISION FOR BAD DEBTS IN THE PERIOD OF SERVICE ON THE BASIS OF ITS PAST EXPERIENCE, WHICH INDICATES THAT SOME PATIENTS ARE UNABLE OR UNWILLING TO PAY THE PORTION OF THEIR BILL FOR WHICH THEY ARE FINANCIALLY RESPONSIBLE. THE DIFFERENCE BETWEEN THE STANDARD RATES (OR THE DISCOUNTED RATES IF NEGOTIATED) AND THE AMOUNTS ACTUALLY COLLECTED AFTER ALL REASONABLE COLLECTION EFFORTS HAVE BEEN EXHAUSTED IS CHARGED OFF AGAINST THE ALLOWANCE FOR DOUBTFUL ACCOUNTS. PART III, LINE 8 - MEDICARE EXPLANATION THE SHORTFALL FOR MEDICARE IS NOT INCLUDED IN THE CHAMBERSBURG HOSPITAL'S COMMUNITY BENEFIT REPORTING. A COST TO CHARGE RATIO WAS USED TO CALCULATE THE MEDICARE ALLOWABLE COST. PART III, LINE 9B - COLLECTION PRACTICES EXPLANATION ALL PATIENTS ARE SUBJECT TO THE DEBT COLLECTION POLICY REGARDLESS OF THEIR ABILITY TO PAY. PART VI, LINE 2 - NEEDS ASSESSMENT HEALTH NEEDS OF FRANKLIN COUNTY RESIDENTS AND SURROUNDING COMMUNITIES ARE ASSESSED THROUGH NUMEROUS RESEARCH METHODS INCLUDING CONDUCTING COMMUNITY HEALTH NEEDS ASSESSMENT IN 2018. THE NEEDS WERE IDENTIFIED BY KEY LEADERS AND NONPROFITS WITHIN THE COMMUNITY. BASED ON SCOPE, SEVERITY, AND COMMUNITY PERCEPTIONS OF SEVERITY AND POTENTIAL IMPACT, AND CONSIDERING THE COMMUNITY INITIATIVES TAKEN SINCE 2015, FRANKLIN COUNTYS MOST SIGNIFICANT NEEDS FOCUS ON TWO SOCIAL DETERMINANTS AND TWO BEHAVIORAL HEALTH PRIORITIES: ESTABLISHING AND MAINTAINING THE BASIC CONDITIONS THAT SUPPORT HEALTH, INCLUDING, ACCESS TO CARE, FAMILY-SUSTAINING INCOMES, ACCESSIBLE TRANSPORTATION, REDUCED STRESS, AND AFFORDABLE AND QUALITY HOUSING ESTABLISHING AND MAINTAINING SYSTEMS THAT ASSURE THAT CHILDREN AND FAMILIES HAVE ACCESS TO HIGH QUALITY EDUCATIONAL OPPORTUNITIES THROUGHOUT THE LIFESPAN SUPPORTING IMPROVED MENTAL HEALTH INCLUDING REDUCING AND TREATING SUBSTANCE USE SUPPORTING ACTIVE LIVING, HEALTHY EATING, AND LESS OBESITY THE COMMUNITY HEALTH NEEDS ASSESSMENT CAN BE FOUND ON OUR WEBSITE AT WWW.SUMMITHEALTH.ORG. PART VI, LINE 3 - PATIENT EDUCATION OF ELIGIBILITY FOR ASSISTANCE PATIENTS ARE MADE AWARE OF THE CHARITY PROGRAM AND OTHER BILLING ASSISTANCE SERVICES AT REGISTRATION, DURING EMERGENCY ROOM VISITS, AND NOTICES PLACED IN SERVICE AREAS. BILLING STATEMENTS ALSO INFORM PATIENTS OF CHARITY CARE AND OTHER BILLING ASSISTANCE PROGRAMS. AVAILABILITY OF CHARITY PROGRAMS IS ALSO LISTED ON OUR WEBSITE. PART VI, LINE 4 - COMMUNITY INFORMATION CHAMBERSBURG HOSPITAL PRIMARILY SERVES COMMUNITY MEMBERS FROM FRANKLIN COUNTY,PA, AND NEARBY COMMUNITIES IN FULTON COUNTY, PA, CUMBERLAND COUNTY, PA, AND WASHINGTON COUNTY, MD. ACCORDING TO U.S. CENSUS DATA, FRANKLIN COUNTY RESIDENTS HAVE A SLIGHTLY LOWER INCOME AND ARE SLIGHTLY OLDER THAN THE STATE AVERAGE. FOR A HEALTH SYSTEM, THIS TYPICALLY RESULTS IN AN INCREASED NEED FOR HEALTHCARE SERVICES. PART VI, LINE 5 - PROMOTION OF COMMUNITY HEALTH CHAMBERSBURG HOSPITAL PROVIDES FINANCIAL AND MANAGERIAL SUPPORT TO KEYSTONE HEALTH, A RURAL HEALTH CENTER THAT SERVICES THE UNDERPRIVILEGED COMMUNITY. IN ADDITION, THE HOSPITAL SUPPORTS LOCAL NONPROFIT ORGANIZATIONS WITH FINANCIAL GRANTS FROM THE SUMMIT ENDOWMENT. WE ENGAGE AND PARTNER WITH OTHER NONPROFITS IN THE COMMUNITY TO ENHANCE AND SUPPORT PROGRAMS AND INITIATIVES THAT ENCOURAGE HEALTHY BEHAVIORS AND LIFESTYLES THROUGH EDUCATION, AWARENESS, AND ACCESS TO SERVICES. PART VI, LINE 6 - AFFILIATED HEALTH CARE SYSTEM THE HOSPITAL IS PART OF WELLSPAN SUMMIT HEALTH, A REGIONAL NETWORK OF TWO HOSPITALS, OUTPATIENT DIAGNOSTIC AND ANCILLARY SERVICES OFFICES, AND HEALTHCARE PROVIDERS. CHAMBERSBURG HOSPITAL AND THESE SUMMIT ENTITIES ARE SERVED BY THE ORGANIZATION'S COMMUNITY HEALTH DEPARTMENT. THIS DEPARTMENT'S MISSION IS TO IMPROVE THE HEALTH OF THE COMMUNITY THROUGH EDUCATION, EARLY DETECTION AND PREVENTION PROGRAMS INCLUDING HEALTH FAIRS, SCREENINGS, AND SEMINARS. MANY OF THE DEPARTMENT'S PROGRAMS ARE PLANNED AND PROVIDED THROUGH COLLABORATION WITH OTHER COMMUNITY ORGANIZATIONS INCLUDING THE PENNSYLVANIA DEPARTMENT OF HEALTH. true CHAMBERSBURG MEMORIAL YMCA 570 E MCKINLEY STREET CHAMBERSBURG PA 17201 231476339 3 8549 HEALTHY EATING MAINSTREET WAYNESBORO INC 13 W MAIN STREET WAYNESBORO PA 17268 232868740 3 6000 NURSE PROGRAM NOAH'S HOUSE RECOVERY HOMES 635 S 4TH STREET CHAMBERSBURG PA 17201 812810826 3 10000 EMOTIONAL SUPPORT SOUTH CENTRAL COMMUNITY ACTION PROG 533 S MAIN STREET CHAMBERSBURG PA 17201 232020123 3 26030 CHILD HEALTHY EATING SUMMIT PHYSICIAN SERVICES 785 5TH AVENUE CHAMBERSBURG PA 17201 251716306 3 109814 HOME MONITORING GREENCASTLE - ANTRIM ENDOWMENT SCHOLARSHIPS 500 EAST LEITERSBURG STREET GREENCASTLE PA 17225 GOV 28000 SCHOLARSHIPS WAYNESBORO AREA BUSINESS EDUCATION AND COMMUNITY FOUNDATION PO BOX 545 WAYNESBORO PA 17268 232678530 3 76976 MENTAL HEALTH AWAREN SOUTH CENTRAL COMMUNITY ACTION PROG 533 S MAIN STREET CHAMBERSBURG PA 17201 232020123 3 5775 POVERTY AND HEALTH SHIPPENSBURG UNIVERSITY FOUNDATION COMMUNITY RESOURCE COALITION 1871 OLD MAIN DRIVE SHIPPENSBURG PA 17257 232046093 3 10000 HEALTHY EATING VARIOUS 1520566 8 1 SCHEDULE I, PAGE 1, PART I, LINE 2 ALL FUNDING DECISIONS ARE MADE BY THE SUMMIT ENDOWMENT COMMITTEE, A COMMITTEE OF THE SUMMIT HEALTH BOARD. THE ENDOWMENT MANAGER PROCESSES GRANT APPLICATIONS, ASSISTS GRANTEES IN DEVELOPING SOUND PROGRAM EVALUATION METHODOLOGIES, RECEIVES AND SUMMARIZES PERIODIC REPORTS, AND VISITS PROGRAM SITES, REPORTING ALL ACTIVITIES TO THE SUMMIT ENDOWMENT COMMITTEE. AS WELL, ENDWOMENT COMMITTEE MEETING MINUTES ARE SHARED WITH WAYNESBORO HOSPITAL'S, CHAMBERSBURG HOSPITAL'S, AND SUMMIT HEALTH'S BOARD OF DIRECTORS. X X true true X X X X false false false false false false false true false PATRICK W O'DONNELL PRESIDENT & CEO 984865 656577 137091 91394 26370 17580 158782 105855 27230 18153 1334338 889559 KIMBERLY M RZOMP TREASURER / VP & CFO 261020 140549 91849 49457 18187 9793 35844 19301 11439 6160 418339 225260 DR KEVIN LORENTSEN DIRECTOR 425633 58365 1677 8250 18172 512097 DR JOSHUA DUNKLEBARGER DIRECTOR 784043 136091 28870 8250 19104 976358 KEVIN MOSSER ENDING 123118 CEO WELLSPAN HEALTH 1023400 420420 2823469 13433 98315 4379037 420420 MICHAEL F O'CONNOR CFO WELLSPAN HEALTH 588737 222300 125 590416 50701 1452279 222300 THOMAS ANDERSON MD VP MEDICAL AFF./CMO 315631 78908 70216 17554 26384 6596 32581 8145 15091 3773 459903 114976 HARRY DIEUVEUIL VP HUMAN RESOURCES 162690 21216 4553 511 22082 211052 JOHN MASSIMILLA VP ADMIN/COO 271318 62308 31788 57801 18867 442082 BARBARA ROSSINI VP PLANNING & COMREL 165527 55176 37991 12663 16446 5481 20782 6928 16641 5547 257387 85795 SHERRI STAHL SR VP HOSPITAL SVCS. 283615 70904 103983 25996 26908 6726 39591 9898 15094 3773 469191 117297 MICHELE ZEIGLER VP INFORMATION SVCS. 180472 77346 40705 17445 20866 8942 35283 15122 6268 2685 283594 121540 CATHY PUHL VP HUMAN RESOURCES 187981 26104 7705 29337 18867 269994 CAROLYN GEORGE VP CORPORATE FINANCE 167367 48540 4613 25366 17036 262922 ELYSE FISLER VP PATIENT SERVICES 169511 23869 444 24585 20445 238854 NANCY PROBST VP QUAL & RISK MGMT 161958 20806 5203 33485 18802 240254 SAMUEL SHATZER VP FOR INFO SYSTEMS 157062 22367 3607 26062 22109 231207 SCHEDULE J, PAGE 1, PART I, LINE 1A THE ORGANIZATION REIMBURSES THE COO FOR DUES ASSOCIATED WITH A SOCIAL CLUB. THE OFFICER RECEIVES AN ALLOWANCE THAT CAN BE CONSIDERED A DISCRETIONARY SPENDING ACCOUNT. THE MONIES ARE IN LIEU OF AN AUTOMOBILE ALLOWANCE, TO PURCHASE ADDITIONAL LIFE INSURANCE, ETC. THESE MONIES ARE INCLUDED IN COMPENSATION AS REPORTED IN THE COMPENSATION OF OFFICERS TABLE. A RESULTS FITNESS CLUB MEMBERSHIP IS AVAILABLE FREE OF CHARGE FOR ANY OFFICER AND ACTIVE BOARD MEMBER. SCHEDULE J, PAGE 1, PART I, LINE 7 INCENTIVE COMPENSATION IS BASED ON PRE-DETERMINED, MEASURABLE GOALS APPROVED BY THE BOARD OF DIRECTORS EXECUTIVE COMMITTEE. THE MEASURABLE GOALS ARE BASED ON QUALITY, COMMUNITY ACCESS TO CARE, PATIENT SAFETY, AND LEADERSHIP. A FCIDA REVENUE BONDS SERIES 2014 2014-04-30 27195000 SEE PART VI false false false B FCIDA REVENUE BOND SERIES 2019A 2019-06-30 109572424 SEE PART VI false false false C FCIDA REVENUE BOND SERIES 2019B 2019-06-30 514919 SEE PART VI false false false A false false false false B false false false false C false false false false A false false false false false false false B false false false false false false false C false false false false false false false A false false false false false false false false false B false false false false false false false false false C false false false false false false false false false A false B false C false SCHEDULE K - ADDITIONAL INFORMATION FCIDA REVENUE BONDS SERIES 2014 213,430,000 OF REVENUE BONDS FOR WELLSPAN HEALTH OBLIGATED GROUP, SERIES 2014A WERE ISSUED NOVEMBER 11, 2014 BY GENERAL AUTHORITY OF SOUTH CENTRAL PENNSYLVANIA. THE PURPOSE OF THIS BOND ISSUE WAS REVENUE REFUND FOR BONDS ISSUED 06/23/1993 AND 11/12/2008. WELLSPAN HEALTH, THE PARENT ORGANIZATION, ALLOCATED PORTIONS OF THE PROCEEDS OF THIS TAX EXEMPT BOND ISSUE TO YORK HOSPITAL (23-1352222), GETTYSBURG HOSPITAL (23-1352220), WELLSPAN PROPERTIES (22-2842252), WELLSPAN SPECIALTY SERVICES (23-2899911), AND EPHRATA COMMUNITY HOSPITAL (23-1370484). IN ORDER TO REMAIN CONSISTENT WITH THE REPORTING ON FORM 8038, ALL OUTSTANDING LIABILITIES ASSOCIATED WITH THIS TAX-EXEMPT BOND ISSUE IS REPORTED ON THE WELLSPAN HEALTH (22- 2517863) SCHEDULE K. AS OF 6/30/19, THE ALLOCATION OF THE DEBT CAPITAL PROGRAM INCLUDING ISSUE PREMIUM WAS AS FOLLOWS: YORK HOSPITAL 115,717,777, GETTYSBURG HOSPITAL 7,778,848, WELLSPAN PROPERTIES 27,853,476, WELLSPAN SPECIALTY SERVICES 13,693,232, AND EPHRATA COMMUNITY HOSPITAL 28,452,517. THESE AMOUNTS ARE REPORTED ON THE RESPECTIVE BALANCE SHEETS FOR EACH OF THESE ENTITIES. ON MAY 22, 2015, THE LANCASTER MUNICIPAL AUTHORITY ISSUED 36,572,083 OF REVENUE BONDS, SERIES 2015A, TO AN OBLIGATED GROUP CONSISTING OF YORK HOSPITAL, GETTYSBURG HOSPITAL AND EPHRATA COMMUNITY HOSPITAL. THE PURPOSE OF THIS BOND ISSUE WAS TO REFUND BONDS ISSUED ON BEHALF OF EPHRATA COMMUNITY HOSPITAL, INCLUDING THE LANCASTER MUNICIPAL AUTHORITY REVENUE NOTES SERIES 2009, 2010A, 2012, AND 2013. IN ORDER TO REMAIN CONSISTENT WITH THE REPORTING ON FORM 8038, ALL OUTSTANDING LIABILITIES ASSOCIATED WITH THIS TAX-EXEMPT BOND ISSUE IS REPORTED ON THE WELLSPAN HEALTH (22- 2517863) SCHEDULE K. AS OF 6/30/19, THE 30,762,699 OF OUTSTANDING LIABILITY IS REPORTED ON THE EPHRATA COMMUNITY HOSPITAL RETURN BALANCE SHEET. 34,877,000 OF REVENUE BONDS FOR WELLSPAN HEALTH OBLIGATED GROUP, SERIES 2017A WERE ISSUED MARCH 13, 2018 BY GENERAL AUTHORITY OF SOUTH CENTRAL PENNSYLVANIA. THE PURPOSE OF THIS BOND ISSUE WAS REVENUE REFUND FOR BONDS ISSUED 11/12/2008. WELLSPAN HEALTH, THE PARENT ORGANIZATION, ALLOCATED PORTIONS OF THE PROCEEDS OF THIS TAX EXEMPT BOND ISSUE TO YORK HOSPITAL (23-1352222), GETTYSBURG HOSPITAL (23-1352220), WELLSPAN PROPERTIES (22- 2842252), WELLSPAN SPECIALTY SERVICES (23-2899911), AND GOOD SAMARITAN HOSPITAL (23-1794160). IN ORDER TO REMAIN CONSISTENT WITH THE REPORTING ON FORM 8038, ALL OUTSTANDING LIABILITIES ASSOCIATED WITH THIS TAX-EXEMPT BOND ISSUE IS REPORTED ON THE WELLSPAN HEALTH (22-2517863) SCHEDULE K. AS OF 6/30/19, THE ALLOCATION OF THE DEBT CAPITAL PROGRAM WAS AS FOLLOWS: YORK HOSPITAL 18,072,754, GETTYSBURG HOSPITAL 2,822,312, WELLSPAN PROPERTIES 3,298,402, WELLSPAN SPECIALTY SERVICES 5,227,656,GOOD SAMARITAN HOSPITAL 252,048, AND WELLSPAN HEALTH 1,443,829. THESE AMOUNTS ARE REPORTED ON THE RESPECTIVE BALANCE SHEETS FOR EACH OF THESE ENTITIES. 29,312,000 OF REVENUE BONDS, SERIES 2017B FOR WELLSPAN HEALTH OBLIGATED GROUP WERE ISSUED 9/4/2018 BY GENERAL AUTHORITY OF SOUTH CENTRAL PENNSYLVANIA. THE PURPOSE OF THE BOND ISSUE WAS REFUND FOR BONDS ISSUED 11/12/2008. IN ORDER TO REMAIN CONSISTENT WITH THE REPORTING ON FORM 8038, ALL OUTSTANDING LIABILITIES ASSOCIATED WITH THIS TAX-EXEMPT BOND ISSUE IS REPORTED ON THE WELLSPAN HEALTH (22-2517863) SCHEDULE K. AS OF 6/30/19, THE ALLOCATION OF THE DEBT CAPITAL PROGRAM WAS AS FOLLOWS: YORK HOSPITAL 16,704,970, GETTYSBURG HOSPITAL 2,608,713 WELLSPAN PROPERTIES 3,048,772, WELLSPAN SPECIALTY SERVICES 4,832,016, GOOD SAMARITAN HOSPITAL 232,972, AND WELLSPAN HEALTH 1,334,557. THESE AMOUNTS ARE REPORTED ON THE RESPECTIVE BALANCE SHEETS FOR EACH OF THESE ENTITIES. 331,502,627 OF REVENUE BONDS SERIES 2019A AND 2019B FOR WELLSPAN HEALTH OBLIGATED GROUP WERE ISSUED 4/3/2019 BY GENERAL AUTHORITY OF SOUTH CENTRAL PENNSYLVANIA. THE PURPOSE OF THIS BOND ISSUE WAS REVENUE REFUND FOR BONDS ISSUED 11/12/2008. WELLSPAN HEALTH, THE PARENT ORGANIZATION, ALLOCATED PORTIONS OF THE PROCEEDS OF THIS TAX EXEMPT BOND ISSUE TO YORK HOSPITAL (23-1352222), CHAMBERSBURG HOSPITAL (23-0465970), WELLSPAN PROPERTIES (22- 2842252), CHAMBERSBURG HEALTH SERVICES (25-1515376), GOOD SAMARITAN HOSPITAL (23-1794160) AND EPHRATA COMMUNITY HOSPITAL (23-1370484). IN ORDER TO REMAIN CONSISTENT WITH THE REPORTING ON FORM 8038, ALL OUTSTANDING LIABILITIES ASSOCIATED WITH THIS TAX-EXEMPT BOND ISSUE IS REPORTED ON THE WELLSPAN HEALTH (22-2517863) SCHEDULE K. AS OF 6/30/19, THE ALLOCATION OF THE DEBT CAPITAL PROGRAM WAS AS FOLLOWS: YORK HOSPITAL 131,706,215, CHAMBERSBURG HOSPITAL 110,087,343, WELLSPAN PROPERTIES 65,734,073, CHAMBERSBURG HEALTH SERVICES 18,810,564, GOOD SAMARITAN HOSPITAL 1,482,627, AND EPHRATA COMMUNITY HOSPITAL 3,472,471. THESE AMOUNTS ARE REPORTED ON THE RESPECTIVE BALANCE SHEETS FOR EACH OF THESE ENTITIES. 212,690,000 OF REVENUE BONDS SERIES 2019C, 2019D AND 2019E FOR WELLSPAN HEALTH OBLIGATED GROUP WERE ISSUED 4/3/2019 BY GENERAL AUTHORITY OF SOUTH CENTRAL PENNSYLVANIA. THE PURPOSE OF THIS BOND ISSUE WAS REVENUE REFUND FOR BONDS ISSUED 11/12/2008. WELLSPAN HEALTH, THE PARENT ORGANIZATION, ALLOCATED PORTIONS OF THE PROCEEDS OF THIS TAX EXEMPT BOND ISSUE TO YORK HOSPITAL (23-1352222), GETTYSBURG HOSPITAL (23-1352220), WELLSPAN PROPERTIES (22-2842252), WELLSPAN SPECIALTY SERVICES (23-2899911), GOOD SAMARITAN HOSPITAL (23-1794160) AND WELLSPAN HEALTH (22-2517863). IN ORDER TO REMAIN CONSISTENT WITH THE REPORTING ON FORM 8038, ALL OUTSTANDING LIABILITIES ASSOCIATED WITH THIS TAX-EXEMPT BOND ISSUE IS REPORTED ON THE WELLSPAN HEALTH (22-2517863) SCHEDULE K. AS OF 6/30/19, THE ALLOCATION OF THE DEBT CAPITAL PROGRAM WAS AS FOLLOWS: YORK HOSPITAL 123,530,352, GETTYSBURG HOSPITAL 19,290,983, WELLSPAN PROPERTIES 22,545,140, WELLSPAN SPECIALTY SERVICES 35,731,920, GOOD SAMARITAN HOSPITAL 1,722,789, AND WELLSPAN HEALTH 9,868,816. THESE AMOUNTS ARE REPORTED ON THE RESPECTIVE BALANCE SHEETS FOR EACH OF THESE ENTITIES. ON APRIL 30, 2014, 35,795,000 OF HEALTHCARE REVENUE BONDS SERIES 2014A & 2014C WERE ISSUED BY FRANKLIN COUNTY INDUSTRIAL AUTHORITY. IN ORDER TO REMAIN CONSISTENT WITH THE REPORTING ON FORM 8038, ALL OUTSTANDING LIABILITIES ASSOCIATED WITH THIS TAX-EXEMPT BOND ISSUE IS REPORTED ON THE WELLSPAN HEALTH (22-2517863) SCHEDULE K. AS OF 6/30/19, THE ALLOCATION OF THE DEBT CAPITAL PROGRAM WAS AS FOLLOWS: WAYNESBORO HOSPITAL (23-1360854) 7,143,140, CHAMBERSBURG HOSPITAL (23-0465970) 21,039,169,AND CHAMBERSBURG HEALTH SERVICES(25-1515376) 499,518. THESE AMOUNTS ARE REPORTED ON THE RESPECTIVE BALANCE SHEETS FOR EACH OF THESE ENTITIES. FORM 990, PAGE 6, PART VI, LINE 6 SUMMIT HEALTH, A 501(C)(3) ENTITY, IS A MEMBER OF THIS ORGANIZATION. FORM 990, PAGE 6, PART VI, LINE 7A SUMMIT HEALTH, A 501(C)(3) ENTITY, ELECTS THE GOVERNING BODY OF THIS ORGANIZATION. FORM 990, PAGE 6, PART VI, LINE 7B SUMMIT HEALTH, A 501(C)(3) ENTITY, HAS CERTAIN RESERVE POWERS OVER THIS ORGANIZATION. FORM 990, PAGE 6, PART VI, LINE 11B PRIOR TO FILING, THE FORM 990 IS REVIEWED BY THE AUDIT COMMITTEE AND PRESENTED TO THE FULL BOARD OF DIRECTORS FOR APPROVAL. FORM 990, PAGE 6, PART VI, LINE 12C MEMBERS ARE ASKED TO ANNUALLY DISCLOSE ANY CONFLICTS OF INTEREST THEY MAY HAVE. FORM 990, PAGE 6, PART VI, LINE 15A THE COMPENSATION IS DISCUSSED WITH AN INDEPENEDENT COMPENSATION COMMITTEE. THIS IS PERFORMED IN CONCERT WITH A COMPENSATION CONSULTANT WHO ASSISTS THE COMMITTEE IN SETTING THE COMPENSATION FOR THESE INDIVIDUALS. FORM 990, PAGE 6, PART VI, LINE 15B THE COMPENSATION IS DISCUSSED WITH AN INDEPENEDENT COMPENSATION COMMITTEE. THIS IS PERFORMED IN CONCERT WITH A COMPENSATION CONSULTANT WHO ASSISTS THE COMMITTEE IN SETTING THE COMPENSATION FOR THESE INDIVIDUALS. FORM 990, PAGE 6, PART VI, LINE 19 GOVERNING DOCUMENTS, CONFLICT OF INTEREST POLICY AND FINANCIAL STATEMENTS ARE AVAILABLE UPON REQUEST. THESE DOCUMENTS ARE HELD IN THE FINANCE DEPARTMENT OF THE CHAMBERSBURG HOSPITAL. HOSPITAL BYLAWS AND ALL POLICIES AND PROCEDURES ARE FOUND ON THE CHAMBERSBURG HOSPITAL INTRANET. FORM 990, PART XI, LINE 9 TRANSFERS TO AFFILIATES -39,359,443 PENSION LIABILITY ADJUSTMENT -36,962,029 CHANGE IN VALUE OF DERIVATIVES -9,130,604 TOTAL -85,452,076 WELLSPAN SUMMIT HEALTH PO BOX 2767 YORK PA 174052767 251515371 HEALTHCARE PA 501C3 7 WELLSPAN H false CHAMBERSBURG HEALTH SERVICES PO BOX 2767 YORK PA 174052767 251515376 HEALTHCARE PA 501C3 12A WELLSPAN S false SUMMIT PHYSICIAN SERVICES PO BOX 2767 YORK PA 174052767 251716306 HEALTHCARE PA 501C3 3 WELLSPAN S false WAYNESBORO HOSPITAL PO BOX 2767 YORK PA 174052767 231360854 HEALTHCARE PA 501C3 3 WELLSPAN S false YORK HOSPITAL PO BOX 2767 YORK PA 174052767 231352222 HEALTHCARE PA 501C3 3 NA false APPLE HILL SURGICAL CENTER INC PO BOX 2767 YORK PA 174052767 222842253 SOLE GP IN PA 501C3 10 NA false GETTYSBURG HOSPITAL PO BOX 2767 YORK PA 174052767 231352220 HEALTH CAR PA 501C3 3 NA false GETTYSBURG HOSPITAL FOUNDATION PO BOX 2767 YORK PA 174052767 232251358 FUNDRAISIN PA 501C3 12A NA false HEALTHY COMMUNITY PHARMACY INC PO BOX 2767 YORK PA 174052767 200519121 REDUCED RA PA 501C3 12A NA false VNA COMMUNITY SERVICES PO BOX 2767 YORK PA 174052767 232338591 HORNE PERS PA 501C3 10 NA false VNA HOME HEALTH SERVICES PO BOX 2767 YORK PA 174052767 231352573 HORNE HEAL PA 501C3 10 NA false WELLSPAN HEALTH PO BOX 2767 YORK PA 174052767 222517863 INTEGRATED PA 501C3 12C NA false WELLSPAN HEALTH CARE SERVICES PO BOX 2767 YORK PA 174052767 232400237 HEALTH-REL PA 501C3 12B NA false WELLSPAN MEDICAL GROUP PO BOX 2767 YORK PA 174052767 232730785 MEDICAL AN PA 501C3 10 NA false YORK HEALTH FOUNDATION PO BOX 2767 YORK PA 174052767 233050192 CHARITABLE PA 501C3 12C NA false WELLSPAN SPECIALTY SERVICES PO BOX 2767 YORK PA 174052767 232899911 SURGERY AN PA 501C3 3 NA false WELLSPAN PROPERTIES INC PO BOX 2767 YORK PA 174052767 222842252 LEASES FAC PA 501C3 12A NA false EPHRATA COMMUNITY HOSPITAL PO BOX 2767 YORK PA 174052767 231370484 HEALTH CAR PA 501C3 3 NA false EPHRATA COMMUNITY HEALTH FOUNDATION PO BOX 2767 YORK PA 174052767 800940005 FUNDRAISIN PA 501C3 12A EPHRATA CO false NORTHERN LANCASTER COUNTY MEDICAL G PO BOX 2767 YORK PA 174052767 203033058 MEDICAL AN PA 501C3 12B EPHRATA CO false PHYS SPEC OF NORTH LANC CO MED PO BOX 2767 YORK PA 174052767 452537633 PHYSICIAN PA 501C3 12B NORTHERN L false GOOD SAMARITAN HOSPITAL PO BOX 2767 YORK PA 174052767 230794160 HEALTH CAR PA 501C3 3 NA false PHILHAVEN PO BOX 2767 YORK PA 174052767 231548822 HEALTH CAR PA 501C3 3 NA false GOOD SAMARITAN HEATH SERVICE FOUNDA PO BOX 2767 YORK PA 174052767 232356151 FUNDRAISIN PA 501C3 12A NA false GOOD SAMARITAN PHYSICIAN SERVICES PO BOX 2767 YORK PA 174052767 251832359 MEDICAL AN PA 501C3 10 NA false SUMMIT SURGERY CENTER LP 785 5TH AVENUE SUITE 3 CHAMBERSBURG PA 17201 251845303 PHYSICIAN PA NA false false 0.00650 SURGERY CENTER ASSOCIATES LLC 785 5TH AVENUE SUITE 3 CHAMBERSBURG PA 17201 251845304 PHYSICIAN PA NA false true 0.01000 APPLE HILL SURGICAL CENTER PARTNERS PO BOX 2767 YORK PA 174052767 232489452 SURGICAL C PA NA false false CENTRAL PA ALLIANCE LABORATORIES LL PO BOX 2767 YORK PA 174052767 232910950 REF. LAB PA NA false false LITTLESTOWN HEALTH CARE PARTNERS 300 WEST KING STREET LITTLESTOWN PA 17340 232880464 LEASE FACI PA NA false false CHERRY TREE CANCER CENTER LLP PO BOX 2767 YORK PA 174052767 232915628 RADIATION PA NA false false THE REHAB CENTER 855 SPRINGDALE DRIVE SUITE 20 EXTON PA 19341 251687903 PHYSICAL T PA NA false false CUMBERLAND VALLEY MOBILE SERVICES LLC 112 NORTH SEVENTH ST CHAMBERSBURG PA 17201 200884014 MOBILE SVC PA NA false false WELLSPAN PHARMACY INC PO BOX 2767 YORK PA 174052767 232374072 DISPENSES PA N/A C CORP false WELLSPAN RECIPROCAL RISK RETEN PO BOX 2767 YORK PA 174052767 200048457 RISK RETEN PA N/A C CORP false YORK HEALTH PLAN PO BOX 2767 YORK PA 174052767 232664989 PREFERRED PA N/A C CORP false WELLSPAN PROVIDER NETWORK PO BOX 2767 YORK PA 174052767 232907828 COORD MNGD PA N/A C CORP false APPLE HILL CONDOMINIUM ASSOCIA PO BOX 2767 YORK PA 174052767 232504543 CONDO MGMT PA N/A C CORP false NORTH LANC CO PHYS HOSP ALLIAN PO BOX 2767 YORK PA 174052767 232421885 COORD PHYS PA N/A C CORP false GSH REALTY INC PO BOX 2767 YORK PA 174052767 251832359 RENTAL NON PA N/A C CORP false EPHRATA HEALTH PAVILION CONDOMINIUM ASSOCIATION PO BOX 2767 YORK PA 174052767 475367279 CONDO ASSO PA N/A C CORP false false false true false false false false false false true true true true false false true true true true WELLSPAN SUMMIT HEALTH C 636432